Dr. Puzanov on Sequencing Targeted Therapy and Immunotherapy in Melanoma

Igor Puzanov, MD, director, Early Phase Clinical Trials Program, chief of Melanoma, coleader, CCSG Experimental Therapeutics Program, professor of Oncology, Department of Medicine, Roswell Park Cancer Institute, discusses an ongoing study exploring the optimal sequence of immunotherapy agents and targeted therapies for patients with melanoma.

One of the most developed combinations is the CTLA-4 inhibitor ipilimumab (Yervoy) plus the PD-1 inhibitor nivolumab (Opdivo), which has been FDA approved for patients with melanoma. The combination has also been explored in these patients who have brain metastases, and it is shown to elicit clinical activity.

Additionally, an Eastern Cooperative Group study is exploring the sequence of BRAF inhibitors plus MEK inhibitors or immunotherapy in BRAF-positive patients in the frontline setting. Patients will undergo a 1:1 randomization for which treatment they will receive first, and then will switch treatments upon disease progression.